Smart Talk

Smart Talk is a daily, live, interactive program featuring conversations with newsmakers and experts in a variety of fields and exploring a wide range of issues and ideas, including the economy, politics, health care, education, culture, and the environment. Smart Talk airs live every week day at 9 a.m. on WITF’s 89.5 and 93.3.

Smart Talk: Heroin in Central PA

It wasn't that long ago that a heroin user would stick a needle in his or her arm to get high in some back alley of a large city -- at least that's what most of us pictured.

Much has changed and not for the better.

Today's heroin can be more pure and powerful, may be mixed with other substances, and cheaper to buy. Users also don't have to "shoot up" to ingest the drug either. At the same time, heroin has found its way into Pennsylvania suburbs and small towns too.

What this means is heroin is a major problem in Pennsylvania and in the Central Pennsylvania region.

York County provides an example. At least 18 people have died from heroin overdoses this year. That's one more than all of last year.

Another difference from the past is prescription drugs seem to be the gateway drug for users. Some go as far as mixing medications and heroin.

This episode of Smart Talk is part of WITF's Transforming Health--a look at the changing tide of healthcare. From policy to personal choices we’re taking a comprehensive look at today’s health system. Online at Transforming Health (dot) org. A partnership of WITF, PinnacleHealth and lead partner WellSpan Health.

WITF joins a statewide broadcast to address the heroin crisis in Pennsylvania. Heroin: A Commonwealth Crisis from Penn State Public Media will simulcast across Pennsylvania including WITF FM and TV at 8:00pm on Thursday May 29.

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Comments: 7

I used heroin and prescription drugs for several years and was fortunate to find treatments that have helped me:

I have been in therapy and taking Suboxone for years and have been able to live a vey happy, healthy, and productive life.

The problem I faced was that the waiting list to see the physician who prescribes Suboxone to me was very long. I was very close to abandoning my seeking recovery because I needed to wait so long to get treatment and it seemed easier to just keep using. I was fortunate to have support during that waiting period but others are not so lucky. I would advocate a combined therapy/medication treatment to others. I also support expanding the availability of these treatments.

I was listening to your show this morning and have a comment. My daughter over dosed on heroin on April 7th. I have been raising her two children for the last two years. It was a slow and painful death. It did start with pain medications, poor relationship boundaries, and led to IV heroin use. Then the crime then the incarcerations; lack of resources for treatment; stigma and the sub culture that is created by the in and out of jail. Nobody knows how to break this epidemic. The legal system gets strapped with it because of the crime that results. There only option is to incarcerate and punish. Unfortunately this only adds to the physical, emotional and sexual abuse. I can only tell you this no one system or strategy is going to solve this problem. It is deep into our society. These kids have no economic opportunities and can not see a way out. I wish I could add more or call in but I am at work. Thank you.

Shannon asks:
With all due respect, gentlemen, many mentally ill individuals do use all kinds of drugs to self-medicate. Again, drug abuse and weapon abuse/mass killing-linked to mental illness! When will our society give it the attention it needs & so badly deserve.

Dr. Peter Hurtubise writes...
I am a physician that prescribes suboxone for heroin and other opioid addictions. I also am a physician who prescribes pain medications. It's very difficult to resolve the two issues in my own practice as often as you have said the gateway to heroin abuse is prescription opioid use. But there are no markers to establish whether or not patients are truly suffering from pain. Additionally, there's a limitation in the number of different medications that are nonnarcotic that can be utilized for the treatment of pain. This lends itself to many unresolvable problems until there are reasonable and rational alternatives.

On a second note I'm very concerned about the emergence of a drug that has been called Scrabble by my patients. This is a mixture of different drugs including ecstasy heroine cocaine benzodiazepines and others that the patient inhales. The ratio of each of the drugs is unknown to the user. This most certainly will lead two deaths of more patients. Can you speak to the emergence of these combination drugs.

I am very glad that this issue is finally getting some attention. I first discovered how serious this problem is when I was celebrating a friend's birthday about six months ago. One person made an off-hand comment about somebody that he knew who had died from a heroin overdose. Jokingly, I responded with a comment like, "How bad could heroin be in little old ...?".

I met three people who graduated from a very small high school who knew 19 individual persons who had died from an opiate overdose among them--with each person being in a different graduating class--that evening. It's one thing to hear the professionals speak about the problem...it's another to hear about the problem from those who were involved, first hand.

I will do my best to re-count what I had discussed with these people that night:

It starts with kids partying and meeting others at a party who are selling opiates. When I asked how these kids got the opiates, I was unanimously given these responses:

1. They steal them from family members to use them, or sell them.

2. People who are prescribed sell them to help pay for their medical bills. These people may or may not legitimately need these pain killers, but some decide to handle the pain out of necessity because of the income they receive from selling their pain medications.

3. Some people who sell them co-ordinate the acquisition of prescription opiate drugs with a doctor--it is usually the case that the doctor is not charged with the crime of distributing the drugs--it is the person who receives the prescription. The doctors, then, receive kickbacks from those for whom he/she writes the prescriptions.

Sometimes these kids, who are relatively inexperienced drug users, come across fentanyl patches. It is popular for people to orally consume the contents of these pain patches, which are highly concentrated opioid compounds meant only for topical use (for things such as severe muscle pain). It is very easy (and common) to overdose this way.

After these kids become users of prescription opiate drugs, there eventually comes a time when the pills (or fentanyl patches) are not available. It's worth re-iterating here that the addictiveness of opiates in not comparable with many other drugs. When the pills run out, the kids turn to using the street drugs (heroin), and then overdose.

Those who are completely disconnected from circles of people who recreationally use drugs likely do not have an accurate concept of how much more dangerous opioids are when compared to other drugs. The movement to exaggerate the dangers of drug use, in order to instill fear in young people with the hopes that they will not do drugs, dilutes the ability of the media to express the severity of today's subject...it's actually worse than it sounded when I heard the program earlier today, in my opinion.

As far as the comment which was made about schools not wanting to report how serious the problem is...all three of these individuals also brought up that very point. There is truth to that statement, at least as far as I am aware through first hand, anecdotal accounts. It would be best for white suburbia to not live in denial about the nature of this problem for the sake of protecting the reputation of the community. The problem pervades society at all levels.

One thing I believe to be certain, though I am not an expert in any way on this topic: The responsibility ultimately lies with the pharmaceutical companies and the doctors. The supply of prescription opiate drugs, seemingly, exceeds legitimate demand--not unlike the supply of street heroin, according to one of the speakers on today's show.

I recognize the usefulness of these drugs for managing pain, and have been prescribed opiate drugs various times (wisdom teeth, recovering from surgery...etc). They were very effective in treating my pain when I needed them. However, I feel grateful that I have never had the desire to abuse these drugs and was thus never faced with the problem of overcoming an addiction to them.

Sarah says...
My family and community have been greatly affected by heroine use. A good first step would be to inform the public about the disease of addiction. ESPECIALLY those involved in the court systems and public service. Specifically the current epidemic straying from prescription drug abuse.

I wanted to make a comment regarding suboxone. While some users may find a positive recovery experience while using suboxone. I know that addicts in active addiction will use Suboxone intravenously in combination with other drugs to mimic the heroine high.